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Regulation of Gait Cycle Phases during Noninvasive Electrical Stimulation of the Spinal Cord

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Abstract

A novel approach was designed to regulate the stepping movements in human by means of noninvasive electrical transcutaneous spinal cord stimulation (TSCS) to activate the flexor/extensor motor pools of the lower limbs in the gait cycle. Selective stimulation was delivered automatically based on signals from gyroscope sensors, which served to detect the stance and swing phases. The initiation of hip extension was a trigger for stimulating extensor pools (L1) during the stance phase, and the initiation of hip flexion was a trigger for stimulating flexor motor pools (T11) during the swing phase. In healthy subjects (n = 6) walking on a treadmill, stimulation at L1 with a frequency of 15 Hz decreased the duration of stance phase by 4% (p = 0.0457), increased the amplitude of movements in the hip joint by 11% (p = 0.0266), decreased the movement amplitude in the ankle joint by 17% (p = 0.0081), and increased EMG activities of the extensors vastus lateralis (VL) (by 31%, p = 0.0441) and gastrocnemius medialis (GM) (by 17%, p = 0.0465) and flexors biceps femoris (BF) (by 26%, p = 0.4637) and tibialis anterior (TA) (by 21%, p = 0.0215) relative to walking without stimulation. Stimulation at Т11 with a frequency of 30 Hz reduced the stance phase duration by 3% (p = 0.0318) and increased the amplitude of movements in the hip joint by 12% (p = 0.0467), the knee lifting by 25% (p = 0.0001), and the terminal anthropometric point height above the surface of support by 19% (p = 0.0001). The changes were accompanied by increases in muscle activities of the flexors BF (by 18%, p = 0.230) and TA (by 14%, p = 0.0170). The reciprocity coefficient decreased in thigh muscles by 15% (p = 0.0301) and increased in shin muscles by 5% (p = 0.0452). Alternating spatiotemporal stimulation at L1 and T11 did not significantly change the durations of the gait cycle and its phases, but changed the kinematic characteristics of movements. The amplitude of movements in the hip joint increased in the stance phase. In the swing phase, higher values were observed for the amplitude of movements in the hip joint, the knee lifting, and the terminal anthropometric point height above the surface of support. EMG activities of thigh and shin muscles increased during stimulation at L1 + T11. EMG activity of extensors was higher than that of flexors in the stance phase, while flexor EMG activity exceeded extensor activity in the swing phase. Thus, the data obtained show the possibility of TSCS selectively to activate the motor pools of the lower extremities, and control their activity to regulate the phases of the stepping cycle during human locomotion.

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ACKNOWLEDGMENTS

We are grateful to N.D. Shandybina for help in analyzing EMGs.

Funding

This work was supported by the project “Development of a Neurostimulatory Device for Regulating Motor Functions in Patients with Sequels of an Acute Cerebrovascular Event” (a grant for cooperation with OOO Cosyma no. 2/2019 dated December 1, 2019) and the program “Basic Research for Long-Term Development and Competitiveness of the Society and State” (project no. AAAA-A18-118050890115-9).

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Authors and Affiliations

  1. Velikie Luki State Academy of Physical Education and Sports, Velikie Luki, Russia

    R. M. Gorodnichev, A. M. Pukhov, S. A. Moiseev, S. M. Ivanov & V. V. Markevich

  2. Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia

    I. N. Bogacheva, A. A. Grishin, T. R. Moshonkina & Yu. P. Gerasimenko

Authors
  1. R. M. Gorodnichev
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  2. A. M. Pukhov
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  3. S. A. Moiseev
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  4. S. M. Ivanov
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  5. V. V. Markevich
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  6. I. N. Bogacheva
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  7. A. A. Grishin
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  8. T. R. Moshonkina
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  9. Yu. P. Gerasimenko
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Correspondence to Yu. P. Gerasimenko.

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Conflict of interests. The authors declare that they have no real or potential conflict of interest.

Statement of compliance with standards of research involving humans as subjects. All procedures performed in studies involving human participants were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments and were approved by the local Ethics Committee at the Velikie Luki State Academy of Physical Education and Sports (Velikie Luki). All individual participants involved in the study voluntarily gave their written informed consent for participation after being informed about the potential risks and benefits and nature of the study.

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Translated by T. Tkacheva

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Gorodnichev, R.M., Pukhov, A.M., Moiseev, S.A. et al. Regulation of Gait Cycle Phases during Noninvasive Electrical Stimulation of the Spinal Cord. Hum Physiol 47, 60–69 (2021). https://doi.org/10.1134/S0362119721010059

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  • DOI: https://doi.org/10.1134/S0362119721010059

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